Massimi, L;
Suaris, T;
Hagen, CK;
Endrizzi, M;
Munro, PRT;
Havariyoun, G;
Hawker, PMS;
... Olivo, A; + view all
(2021)
Detection of involved margins in breast specimens with x-ray phase-contrast computed tomography.
Scientific Reports
, 11
, Article 3663. 10.1038/s41598-021-83330-w.
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Abstract
Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase contrast imaging (XPCI) provides soft tissue sensitivity superior to conventional X-rays: we propose its use to detect margin involvement intraoperatively. We have developed a system that can perform phase-based computed tomography (CT) scans in minutes, used it to image 101 specimens approximately half of which contained neoplastic lesions, and compared results against those of a commercial system. Histological analysis was carried out on all specimens and used as the gold standard. XPCI-CT showed higher sensitivity (83%, 95% CI 69–92%) than conventional specimen imaging (32%, 95% CI 20–49%) for detection of lesions at margin, and comparable specificity (83%, 95% CI 70–92% vs 86%, 95% CI 73–93%). Within the limits of this study, in particular that specimens obtained from surplus tissue typically contain small lesions which makes detection more difficult for both methods, we believe it likely that the observed increase in sensitivity will lead to a comparable reduction in the number of re-operations.
| Type: | Article |
|---|---|
| Title: | Detection of involved margins in breast specimens with x-ray phase-contrast computed tomography |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1038/s41598-021-83330-w |
| Publisher version: | https://doi.org/10.1038/s41598-021-83330-w |
| Language: | English |
| Additional information: | This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10120617 |
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